2011 Military Health System Conference. Medical Response to Haiti Earthquake Operation Unified Response

Transcription

1 2011 Military Health System Conference Medical Response to Haiti Earthquake Operation Unified Response The Quadruple Aim: Working Together, Achieving Success CAPT Michele Hancock, Deputy SG, US Southern Command 24 January 2011

2 Report Documentation Page Form Approved OMB No Public reporting burden for the collection of information is estimated to average 1 hour per response, including the time for reviewing instructions, searching existing data sources, gathering and maintaining the data needed, and completing and reviewing the collection of information. Send comments regarding this burden estimate or any other aspect of this collection of information, including suggestions for reducing this burden, to Washington Headquarters Services, Directorate for Information Operations and Reports, 1215 Jefferson Davis Highway, Suite 1204, Arlington VA Respondents should be aware that notwithstanding any other provision of law, no person shall be subject to a penalty for failing to comply with a collection of information if it does not display a currently valid OMB control number. 1. REPORT DATE 24 JAN REPORT TYPE 3. DATES COVERED to TITLE AND SUBTITLE Medical Response to Haiti Earthquake: Operation Unified Response 5a. CONTRACT NUMBER 5b. GRANT NUMBER 5c. PROGRAM ELEMENT NUMBER 6. AUTHOR(S) 5d. PROJECT NUMBER 5e. TASK NUMBER 5f. WORK UNIT NUMBER 7. PERFORMING ORGANIZATION NAME(S) AND ADDRESS(ES) US Southern Command,9301 NW 3rd St,Doral,FL, PERFORMING ORGANIZATION REPORT NUMBER 9. SPONSORING/MONITORING AGENCY NAME(S) AND ADDRESS(ES) 10. SPONSOR/MONITOR S ACRONYM(S) 12. DISTRIBUTION/AVAILABILITY STATEMENT Approved for public release; distribution unlimited 11. SPONSOR/MONITOR S REPORT NUMBER(S) 13. SUPPLEMENTARY NOTES presented at the 2011 Military Health System Conference, January 24-27, National Harbor, Maryland 14. ABSTRACT 15. SUBJECT TERMS 16. SECURITY CLASSIFICATION OF: 17. LIMITATION OF ABSTRACT a. REPORT unclassified b. ABSTRACT unclassified c. THIS PAGE unclassified Same as Report (SAR) 18. NUMBER OF PAGES 29 19a. NAME OF RESPONSIBLE PERSON Standard Form 298 (Rev. 8-98) Prescribed by ANSI Std Z39-18

3 Agenda Background Info Mission Phases of Support Deployment Timeline Medical Missions International Response Lessons Learned 2

4 Background Info Population: 9,035,536 (approximately 2 million in and around Port-Au-Prince) NGOs on the ground for many years, ~3000 in country Unemployment rate: 65-70% -- 80% population living under poverty line -- 54% in abject poverty Military: Only small Coast Guard (no other forces)

5 UNCLASSIFIED Scope of Disaster A Magnitude 7.0 earthquake struck Haiti at 4:53 pm, Tues, Jan 12, ,000 Deaths* 197,000 Injured 1.1M Displaced People 3,000,000 Affected People 60% of government infrastructure destroyed 14 of 16 Ministry Headquarters destroyed UNCLASSIFIED

6 Mission Overview Mission: JTF-H conducts humanitarian assistance/ disaster relief (HA/DR) operations to support USG efforts in Haiti to mitigate near-term human suffering and accelerate relief efforts to facilitate transition to Government of Haiti, United Nations, and USAID.

7 Phase I Emergency Response Immediate Life Saving Search and Rescue Care for AMCITS Hospital Assessments Medical CONOPS RSO&I of Medical Personnel Medevacs 6

8 Phase II Relief Mitigate Suffering and Meet Basic Needs Specialized surgical care Med Log and blood support Patient transfers off ship Medevacs Troop FHP 7

9 Deployment Timeline (January) AFSOC Arrives SJFHQ Arrives VINSON Arrives B CO, 1/73 CAV (82 ABN) Arrives JTF-B MEDEL Operational BATAAN ARG Arrives First AMC Executed Evacuation COMFORT Arrives EMEDS+10 Arrives AF CCAT & PM-SAT Operational MASF & AELT Arrive NASSAU ARG Arrives Aftershock First HHS Personnel Arrive First evacuation of Haitian nationals Evacuation of Haitians Suspended Magnitude 7.0 Earthquake vic. Port au Prince

10 Deployment Timeline (February) Decision Made NOT to Employ EMF-150 AE Review Board Established COMFORT Surg Augments Redeploy USS VINSON Departs 153 rd Blood Support Det Arrives 43 rd Veterinary Det Arrives th MMB Arrives AE Review Board Suspended Definitive Care Components of NDMS Activated Evacuation of Haitians Resumes Commercial Flights Resume From PaP

11 Deployment Timeline (March) USTC AE Enablers Redeploy EMEDS + 10 Redeploys COMFORT Redeploys JTF-H Conducts RIP w/arsouth DHHS Stands Down FCCs Final DHHS Treatment Asset Redeploys NDMS Officially Stood Down

12 EARTHQUAKE INTENSITY The Modified Mercalli (MMI) Intensity Scale* NORTHWEST 45,862 NORTH 13,531 NORTHEAST 8,500 POPULATION MOVEMENT* Source: OCHA * Population movements indicated include only individuals utilizing GoH provided transportation and do not include people leaving Port-au-Prince utilizing private means of transport. H A I T I E A R T H Q U A K E 230,000 killed 196,595 injured 1,200,000 to 1,290,000 displaced 3,000,000 affected *All figures are approximate. Commune population figures are as of SOURCES: OCHA/GoH ARTIBONITE 162,509 CENTER 90,997 GRANDE ANSE 119,871 GRESSIER* 40-50% destroyed Commune population: 25,947 CARREFOUR* 40-50% destroyed Commune population: 373,916 NIPPES 33,351 WEST 35,253 PORT AU PRINCE* 30-40% destroyed Commune population: 704,776 Metro Population estimate: 2,000,000 DOMINICAN REPUBLIC Unconfirmed Numbers SOUTH 88,533 PETIT GOAVE* 15% destroyed Commune population: 117,504 LÉOGÂNE* 80-90% destroyed Commune population: 134,190 JACMEL* 50-60% destroyed Commune population: ,966 11

13 Afloat Based Medical Support

14 Maritime Laydown VINSON (CVN) USNS COMFORT (T-AH) NORMANDY (CG) BUNKER HILL (CG) HIGGINS (DDG) UNDERWOOD (FFG) NASSAU ARG with 24 MEU: NASSAU (LHD) MESA VERDE (LPD) ASHLAND (LSD) BATAAN ARG with 22 MEU: BATAAN (LHD) FORT MCHENRY (LSD) CARTER HALL (LSD) GUNSTON HALL (LSD) 13

15 COMFORT Timeline Phase I Phase II Transition to Redeployment Max Patient Capacity 1002 total admissions (872 patients, 130 escorts) 931 surgical procedures Patients Aboard Surgeries Patient Discharges Patients Admitted 1/12 1/19 1/26 2/2 2/9 2/16 2/23 3/2 3/9 12 Jan: Haiti hit by earthquake 15 Jan: MTF FOS crew, initial NGO embark 20 Jan: CDS40 Embark 19 Jan: First HN patient aboard 16 Jan: COM deploys 28 Jan: Peak census: Feb: NGO surgical augment team aboard 27 Feb: Last HN patient discharge 26 Feb: Last HN surgical procedure 10 Mar: COM redeploys

16 Land Based Medical Support Placeholder AS OF: 1500, 13 MAR

17 JTF-H MEDICAL COP Phase I: o/a 20JAN RFEB AIR YF Ws x 34 each - BCT/BN HQ FDPMU YF Distribution Hubs Haitian Hosp Hosp Embassy LEVEL II EMEDS YF BLACK LV I Tailgate YF Ws x 17 each MASF/SPEARR/AE LT/AFSOC SOST(-) YF BSTB YF Tailgate Med 68Ws x 10 each AIR YF Tailgate MED 68Ws x 33 each 1-73 CAV LV I YF Ws x 23 each LEVEL II YF Ws x 44 each JTF HQ YF AFSOC SOST Colombian MED Tm Mexican Surgical Tm JTF-B FST/Colombian Surg/Mexican Surg YF Interim After Care Facility YF

18 Served as Gate keeper 10+ beds and 1 OR 300 patients and 200 escorts moved 125 inpatients rec vd care EMEDS Response 12 day trips Assisted 3 NGO s 1500 patients seen 4 tons medical supplies

19 Medical Logistics Support Support to PROMESS Warehouse Logistics Advisory Team Re-organized warehouse Provided inventory mgmt Teams at port to organize donations Forklift support 18

20 Patient Movement Missions Ground ambulance Rotary wing medevac Small boat medevac Evac to GTMO and CONUS 19

21 Patient Movement CONUS NDMS Started NDMS Ended AE Staging MacDill, AFB GITMO Naval Hospital Port-au-Prince APOE 20

22 Patient Operation Movement UNIFIED = Total RESPONSE Jan 16 Jan 18 Jan 20 Jan 22 Jan 24 Jan 26 Jan 28 Jan 30 Jan 1 Feb 3 Feb 5 Feb 7 Feb 9 Feb 11 Feb 13 Feb 15 Feb 17 Feb 19 Feb 21 Feb 23 Feb 25 Feb 27 Feb 1 Mar 3 Mar 5 Mar 7 Mar 9 Mar 11 Mar 13 Mar 15 Mar Unclassified Contingency PM Report Airlift Sourcing Other DoS AMC AFSOC Patient Movement Breakout ISSUES: 1. Supporting DoD Haiti Patient Movement Requirements 2. Supporting DoD Chilean Patient Movement Requirements A/O 1200Z14APR10

23 Patient Outflow within Haiti Children of Promise** 1 Sacred Heart** 45 Partners in Health 14 Real Hope for Haiti 10 Love a Child 90 Killick 9 Terminal Varreux 360 St. Damien s Children s Hospital** 30 Heart Line 12 Angel Missions 10 Gheskio Hospital 1 PIH / Double Harvest** 4 Doctors without Borders 3 Canadian Field Hospital 3 St. Bonaface** 25 Aerovac 77 UNCLAS//FOUO GoH / UN approved shore-based medical network provided placement of COMFORT patients for post-operative care

24 International Response Medical Forces Afloat SPS CASTILLA ITN CAVOUR FRS SIROCCO ARM HUASTECO ARM TARRASCO ARM PAPALOAPAN ARC BUENAVENTURA ARC CARTAGENA DE INDIAS Medical Forces Ashore Canadian Field Hospital Russia- Mobile Hospital China- Medical Rescue Team Brazil- Field Hospital Chile-Portable Hospitals Turkey- Field Hospital Japan- Medical team France- Field Hospital Jordan - Field Hospital Venezuela- Medical Team Israel- Field Hospital Cuba- Medical Team Spain- Medical Team Italy- Medical Team 23

25 AAR: What we did well Interagency Coordination - Pre-crisis professional relationships and routine interagency coordination proved to be essential during the response. Collaboration and Synchronization (Strategic) - The USSC SG daily TELECON provided vital situational awareness, identified critical issues, and assisted in assigning responsibility for actions.

26 AAR: What we did well Collaboration and Synchronization (Operational) USAID sponsored daily USG health meetings to pass information from UN Health Cluster and prioritize USG medical response. Operational Environmental Risk Surveillance. Forward Deployed Prev Med Unit (FDPMU) arrived early in deployment and was fully mission capable.

27 AAR: What Needed Improvement Delay in USG and DoD Policy Concerning Evacuation of Haitian and Foreign Nationals Delay in Activation of NDMS Definitive Care Component and Non-Activation of NDMS Patient Movement (PM) Component Delay in establishing Medical ROE

28 AAR: What Needed Improvement No designated medical rep on OFDA Disaster Assistance Response Team (DART) COMFORT not initially configured for FDR mission No Interagency Common Operating Picture JMEWS not used

29 Final Words of Wisdom Clearly define mission of DoD medical forces Maintain close coordination with OFDA Partner with NGO s and international community Collaborate, don t work in a vacuum Develop transition criteria and decision points 28

30 Unity of Effort At All Levels